A national population-based study of pregnancy complications and adverse birth outcomes: The importance of women's preconception mental health

Purpose: We sought to determine if and to what extent women's preconception mental health status impacted subsequent pregnancy complications, non-live birth, and birth weight using a nationally representative population-based sample.

Methods: Data are from the 1996-2006 Medical Expenditure Panel Survey (MEPS), a national, population-based panel survey. We examined data on 3,373 mothers from eleven panels of the MEPS. Preconception mental health was defined as women's report of symptoms of mental health conditions or a global mental health rating of “fair” or “poor” before conception. Questions about pregnancy complications and birth outcomes were asked as part of the Pregnancy Detail File of the MEPS and self-reported by women.

Results: 6.8% of pregnant women reported poor mental health prior to pregnancy. Poor mental health prior to pregnancy was associated with an increased odds of experiencing any pregnancy complication (OR 1.40, 95% CI: 1.02 - 1.92), having a non-live birth (OR 1.71, 95% CI: 1.14 - 2.58) and having a low birth weight baby (OR 2.07, 95% CI: 1.04 - 4.09), all controlling for maternal age, race/ethnicity, marital status, education, health insurance status, and income.

Conclusions: Women's preconception mental health problems appear to be an important predictor of pregnancy complications for women, and non-live birth and low birth weight for babies. Accordingly, healthcare providers should strive to identify and treat women's preconception mental health problems in an effort to improve the survival, long-term health, quality of life, and well-being of children and their families.